ArticleWorld journal of urology2026
Flexible and navigable suction ureteral access sheath's impact on ureteroscope deflection.
Article in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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Who cites it
2 citing papers in PubMed.
- Benchtop comparison of seven ureteroscopes: evaluating physical properties and deflection with flexible and navigable suction access sheaths.BJU international · 2026Article
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9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionRetrograde intrarenal surgery with flexible ureteroscopes (FURS) is considered gold-standard for treatment of small renal stones, and this procedure often employs the use of a ureteral access sheath. Recently, flexible and navigable suction access sheaths (FANS) have entered the market. FANS are usually bent together with the FURS, which could reduce the maximum deflection angle of the ureteroscope. This study aims to report FURS´ deflection angle loss when employing FANS. MATERIALS AND
methodsActive downward deflection was measured in vitro in all possible permutations between different FURS, FANS, and working channel instruments. 8 different flexible ureteroscopes were utilized. FANS (ClearPetra™, Well Lead Medical®, China) included multiple diameters from 10/12 to 13/15 Fr. Two deflection techniques were utilized: 1) Sheath Advancement: deflecting the FURS first and advancing the FANS over the scope, and 2) Ureteroscope Deflection: deflecting both the FANS and scope together by having the FURS tip and the distal tip of the FANS.
resultsA total of 120 measurements were determined. Ureteroscope shaft size was not associated with deflection loss (DL), for all scenarios except when using no fiber and sheath advancement technique (p < 0.05). When controlling for FANS sizes, larger sheaths statistically increased the DL, regardless of technique or working channel occupancy, with all p values < 0.01. In every scenario, DL was higher when using ureteroscope deflection technique than sheath advancement (p < 0.001), with higher difference when the working channel was free without laser fibers (p < 0.05).
conclusionsWhile all FURS presented deflection loss when using FANS, smaller FANS diameters were associated with less DL. Preoperative planning with selection of the optimal FANS diameter for the specific FURS utilized may allow for maximal suction without compromising the deflection needed for precise navigation in the collection system to the desired calyx.
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Registered trials
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